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Updated: Oct 1, 2026
Electrically Evoked Stapedius Reflex Measurements in Cochlear Implantation and Its Application in the Postoperative Fitting Process
Published on: June 21, 2024
Intraoperative electrically evoked stapedial reflex thresholds (eSRT) for cochlear implant programming: a
Eric Cunningham1, Isabelle J Chau1, Rivka Bornstein2
1School of Medicine, New York Medical College, Valhalla, NY, USA.
Objective:
To determine if intraoperative electrically evoked stapedial reflex thresholds (eSRT) correlate with postoperative eSRT and can predict programming levels in cochlear implant patients.
Design:
Prospective cohort study conducted at a tertiary hospital. Seventy-seven patients who underwent cochlear implant surgery were included. Intraoperative and postoperative eSRT testing was performed at electrodes E1, E6, E12, E17, and E22, with postoperative testing conducted at a median of 4 weeks.
Results:
Eighty-four cochlear implants in 77 patients met inclusion criteria, with intraoperative eSRT attempted in 72 ears and postoperative testing in 50. Intraoperative response rates were significantly higher than postoperative rates overall (83.1% vs. 70.9%, p = 0.0005), with the highest rates at middle and apical electrodes. Median intraoperative thresholds were significantly higher than postoperative thresholds (21.2 vs. 15.6, p < 0.0001), but no significant correlations were observed between the two time points.
Conclusion:
Intraoperative eSRT was feasible and yielded high response rates, particularly at apical and middle electrodes. However, intraoperative thresholds did not correlate with early postoperative values and cannot currently predict early postoperative eSRTs. These findings support the utility of intraoperative eSRT as a qualitative intraoperative tool, but further refinement is needed to improve its predictive value for postoperative cochlear implant programming.